Table 1.
Patient Demographics
| Variable | Missing Data | Standard of Care (N = 3,076) | Steroids Only (n = 1,383) | Steroids Plus Tocilizumab (n = 454) | Steroids Plus Anakinra (n = 733) | Tocilizumab Only (n = 73) | Anakinra Only (n = 57) | P Value |
|---|---|---|---|---|---|---|---|---|
| Demographics | ||||||||
| Age, y | 64.6 (53.5-76.4) | 66.5 (55.8-76.9) | 64.5 (54.9-73.1) | 65.7 (56.5-74.7) | 62.4 (55.1-68.7) | 66.7 (57.6-74.6) | .01 | |
| Sex | ||||||||
| Female | 1,185 (38.5) | 489 (35.4) | 123 (27.1) | 238 (32.5) | 21 (28.8) | 19 (33.3) | < .0001 | |
| Male | 1,891 (61.5) | 894 (64.6) | 331 (72.9) | 495 (67.5) | 52 (71.2) | 38 (66.7) | ||
| Race | ||||||||
| White | 1,021 (33.2) | 474 (34.3) | 163 (35.9) | 208 (28.4) | 239(39.7) | 12 (21.1) | .0013 | |
| Black | 656 (21.3) | 293 (21.2) | 68 (15) | 139 (19) | 8 (11) | 17 (29.8) | ||
| Asian | 372 (12.1) | 161 (11.6) | 64 (14.1) | 98 (13.4) | 8 (11) | 1 (1.8) | ||
| Other/multiracial | 867 (28.2) | 372 (26.9) | 132 (29.1) | 243 (33.2) | 24 (32.9) | 23 (40.4) | ||
| Unknown | 160 (5.2) | 83 (6) | 27 (5.9) | 45 (6.1) | 4 (5.5) | 4 (7) | ||
| Ethnicity | ||||||||
| Hispanic or Latino | 671 (21.8) | 319 (23.1) | 119 (26.2) | 171 (23.3) | 13 (17.8) | 12 (21.1) | .41 | |
| Non-Hispanic or Latino | 2,141 (69.6) | 944 (68.3) | 295 (65) | 513 (70) | 55 (75.3) | 42 (73.7) | ||
| Other/unknown | 264 (8.6) | 120 (8.7) | 40 (8.8) | 49 (6.7) | 5 (6.8) | 3 (5.3) | ||
| Insurance | ||||||||
| Commercial | 916 (29.8) | 410 (29.6) | 159 (35) | 230 (31.4) | 35 (47.9) | 15 (26.3) | < .0001 | |
| Medicare | 1,354 (44) | 656 (47.4) | 178 (39.2) | 319 (43.5) | 26 (35.6) | 27 (47.4) | ||
| Medicaid | 634 (20.6) | 271 (19.6) | 103 (22.7) | 162 (22.1) | 12 (16.4) | 14 (24.6) | ||
| Self-pay | 49 (1.6) | 30 (2.2) | 7 (1.5) | 15 (2) | 0 (0) | 0 (0) | ||
| Other | 123 (4) | 16 (1.2) | 7 (1.5) | 7 (1) | 0 (0) | 1 (1.8) | ||
| Smoking status | ||||||||
| Active | 67 (2.2) | 22 (1.6) | 10 (2.2) | 18 (2.5) | 1 (1.4) | 2 (3.5) | .15 | |
| Former | 426 (13.8) | 212 (15.3) | 71 (15.6) | 107 (14.6) | 13 (17.8) | 9 (15.8) | ||
| Never | 2,203 (71.6) | 971 (70.2) | 305 (67.2) | 523 (71.4) | 54 (74) | 41 (71.9) | ||
| Smoker/status unknown | 122 (4) | 38 (2.7) | 17 (3.7) | 14 (1.9) | 3 (4.1) | 2 (3.5) | ||
| Unknown | 258 (8.4) | 140 (10.1) | 51 (11.2) | 71 (9.7) | 2 (2.7) | 3 (5.3) | ||
| Hospital status | ||||||||
| Community | 1,108 (36) | 414 (29.9) | 142 (31.3) | 169 (23.1) | 17 (23.3) | 15 (26.3) | < .0001 | |
| Tertiary | 1,968 (64) | 969 (70.1) | 312 (68.7) | 564 (76.9) | 56 (76.7) | 42 (73.7) | ||
| Comorbidities | ||||||||
| BMI, kg/m2 | 808 (14) | |||||||
| 18.5-24.9 | 666 (25.9) | 270 (22.1) | 75 (18.2) | 152 (23.2) | 23 (37.1) | 18 (36.7) | .004 | |
| < 18.5 | 286 (11.1) | 139 (11.4) | 41 (10) | 71 (10.8) | 1 (1.6) | 5 (10.2) | ||
| 25-29.9 | 821 (31.9) | 405 (33.2) | 149 (36.3) | 215 (32.8) | 14 (22.6) | 12 (24.5) | ||
| ≥ 30 | 799 (31.1) | 405 (33.2) | 146 (35.5) | 217 (33.1) | 24 (38.7) | 14 (28.6) | ||
| Charlson comorbidity index | 1 (0.02) | |||||||
| 0 | 333 (10.8) | 102 (7.4) | 30 (6.6) | 48 (6.5) | 4 (5.5) | 3 (5.3) | < .0001 | |
| 1-2 | 683 (22.2) | 184 (20.5) | 127 (28) | 182 (24.8) | 14 (19.2) | 15 (26.3) | ||
| 3-4 | 710 (23.1) | 353 (25.5) | 133 (29.3) | 221 (30.2) | 26 (35.6) | 14 (24.6) | ||
| ≥ 5 | 1,349 (43.9) | 644 (46.6) | 164 (36.1) | 282 (38.5) | 29 (39.7) | 25 (43.9) | ||
| Asthma | 134 (4.4) | 105 (7.6) | 25 (5.5) | 48 (6.5) | 9 (12.3) | 2 (3.5) | .01 | |
| COPD | 88 (2.9) | 67 (4.8) | 14 (3.1) | 31 (4.2) | 1 (1.4) | 3 (5.3) | .02 | |
| HTN | 1,454 (47.3) | 682 (49.3) | 224 (49.3) | 379 (51.7) | 43 (58.9) | 25 (43.9) | .11 | |
| DM | 980 (31.9) | 460 (33.3) | 154 (33.9) | 241 (32.9) | 27 (37) | 26 (45.6) | .27 | |
| Cardiovascular disease | 393 (12.8) | 181 (13.1) | 59 (13) | 88 (12) | 10 (13.7) | 3 (5.3) | .63 | |
| CKD_ESRD | 11 (0.2) | 356 (11.6) | 145 (10.5) | 29 (6.4) | 55 (7.5) | 4 (5.5) | 5 (8.8) | .001 |
| Hemodialysis | 43 (1.4) | 4 (0.3) | 1 (0.2) | 7 (1) | 0 (0) | 0 (0) | .01 | |
| Cancer | 178 (5.8) | 86 (6.2) | 33 (7.3) | 49 (6.7) | 8 (11) | 5 (8.8) | .35 | |
| Chronic liver disease | 19 (0.6) | 5 (0.4) | 4 (0.9) | 4 (0.5) | 0 (0) | 0 (0) | .75 | |
| Autoimmune disease | 38 (1.2) | 31 (2.2) | 8 (1.8) | 15 (2) | 0 (0) | 1 (1.8) | .14 | |
| Interstitial lung disease | 52 (1.7) | 64 (4.6) | 43 (9.5) | 27 (3.7) | 7 (9.6) | 1 (1.8) | < .0001 | |
| Severity of illness surrogates | ||||||||
| Mechanical ventilation | 143 (4.6) | 82 (5.9) | 35 (7.7) | 30 (4.1) | 7 (9.6) | 1 (1.8) | .01 | |
| Vasopressor use | 89 (2.9) | 50 (3.6) | 18 (4) | 18 (2.5) | 3 (4.1) | 1 (1.8) | .49 | |
| Laboratory data | ||||||||
| CRP, mg/dL | 738 (12.8) | |||||||
| 0-0.5 | 21 (0.8) | 1 (0.1) | 1 (0.2) | 3 (0.5) | 0 (0) | 0 (0) | < .0001 | |
| > 0.5-2.5 | 164 (6.3) | 32 (2.6) | 3 (0.7) | 4 (0.6) | 0 (0) | 0 (0) | ||
| > 2.5 | 2,405 (92.9) | 1,211 (97.3) | 427 (99.1) | 645 (98.9) | 68 (100) | 53 (100) | ||
| D-dimer, ng/mL DDU | 2,026 (35.1) | |||||||
| < 230 | 350 (19.1) | 112 (12.5) | 56 (16) | 80 (14.1) | 18 (30) | 4 (8.3) | .0002 | |
| 230-1150 | 1,129 (61.8) | 582 (65.1) | 222 (63.2) | 360 (63.3) | 31 (51.7) | 33 (68.8) | ||
| > 1150 | 349 (19.1) | 200 (22.4) | 73 (20.8) | 129 (22.7) | 11 (18.3) | 11 (22.9) | ||
| Serum ferritin, ng/mL | 615 (10.7) | |||||||
| < 30 | 1 (0) | 2 (0.1) | 1 (0.2) | 1 (0.1) | 0 (0) | 0 (0) | < .0001 | |
| 30-400 | 423 (15.7) | 182 (14.5) | 28 (6.5) | 59 (8.8) | 7 (10.9) | 4 (7.7) | ||
| > 400-2000 | 1,783 (66.3) | 805 (64.2) | 307 (71.6) | 457 (68) | 49 (76.6) | 34 (65.4) | ||
| > 2000 | 484 (18) | 264 (21.2) | 93 (21.7) | 155 (23.1) | 8 (12.5) | 14 (26.9) | ||
| LDH, U/L | 991 (17.1) | |||||||
| < 242 | 106 (4.2) | 20 (1.7) | 1 (0.3) | 5 (0.8) | 3 (5.5) | 3 (5.6) | < .0001 | |
| ≥ 242 | 2,413 (95.8) | 1,170 (98.3) | 341 (99.7) | 620 (99.2) | 52 (94.5) | 51 (94.4) | ||
| Hemoglobin, g/dL | 121 (2.1) | |||||||
| < 11.5 | 767 (25.4) | 304 (22.5) | 55 (12.4) | 117 (16.3) | 16 (21.9) | 11 (20.8) | < .0001 | |
| 11.5-15.5 | 2,025 (67.1) | 938 (69.4) | 343 (77.6) | 546 (76.3) | 52 (71.2) | 34 (64.2) | ||
| > 15.5 | 227 (7.5) | 110 (8.1) | 44 (10) | 53 (7.4) | 5 (6.8) | 8 (15.1) | ||
| Eosinophils, K/μL | 310 (5.4) | |||||||
| 0-0.5 | 2,891 (99.6) | 1,307 (99.8) | 435 (100) | 697 (99.9) | 69 (100) | 52 (100) | .56 | |
| > 0.5 | 12 (0.4) | 2 (0.2) | 0 (0) | 1 (0.1) | 0 (0) | 0 (0) | ||
| Neutrophil-to-lymphocyte ratio | 321 (5.6) | |||||||
| < 0.75 | 23 (0.8) | 5 (0.4) | 2 (0.5) | 2 (0.3) | 0 (0) | 0 (0) | < .0001 | |
| 0.75-4 | 823 (28.4) | 227 (17.4) | 70 (16.1) | 93 (13.5) | 15 (21.4) | 12 (23.5) | ||
| > 4-20 | 1,879 (64.7) | 939 (72) | 309 (70.9) | 518 (75) | 48 (68.6) | 34 (66.7) | ||
| > 20 | 177 (6.1) | 134 (10.3) | 55 (12.6) | 78 (11.3) | 7 (10) | 5 (9.8) | ||
| Platelets, K/μL | 129 (2.2) | |||||||
| < 150 | 615 (20.4) | 271 (20.1) | 91 (20.6) | 128 (17.9) | 15 (20.5) | 9 (17) | .42 | |
| 150-500 | 2,348 (77.9) | 1,062 (78.8) | 347 (78.5) | 572 (80) | 58 (79.5) | 42 (79.2) | ||
| > 500 | 53 (1.8) | 15 (1.1) | 4 (0.9) | 15 (2.1) | 0 (0) | 2 (3.8) | ||
| Serum sodium, mM | 53 (0.9) | |||||||
| < 135 | 913 (29.9) | 440 (32.1) | 191 (42.6) | 314 (43.3) | 25 (34.7) | 22 (39.3) | < .0001 | |
| 135-145 | 1,921 (62.9) | 835 (60.9) | 248 (55.4) | 380 (52.3) | 43 (59.7) | 32 (57.1) | ||
| > 145 | 218 (7.1) | 95 (6.9) | 9 (2) | 32 (4.4) | 4 (5.6) | 2 (3.6) | ||
| Alanine aminotransferase, IU/L | 153 (2.7) | |||||||
| < 40 | 1,667 (55.8) | 741 (54.9) | 219 (49.5) | 371 (51.5) | 44 (63.8) | 31 (55.4) | .06 | |
| 40-200 | 1,235 (41.4) | 578 (42.8) | 208 (47.1) | 338 (46.9) | 24 (34.8) | 23 (41.1) | ||
| > 200 | 84 (2.8) | 30 (2.2) | 15 (3.4) | 12 (1.7) | 1 (1.4) | 2 (3.6) | ||
| Aspartate aminotransferase, IU/L | 151 (2.6) | |||||||
| < 40 | 1,090 (36.5) | 360 (26.7) | 97 (21.9) | 173 (24) | 30 (43.5) | 13 (23.2) | < .0001 | |
| 40-200 | 1,767 (59.1) | 946 (70.1) | 327 (74) | 526 (73) | 30 (43.5) | 39 (69.6) | ||
| > 200 | 131 (4.4) | 43 (3.2) | 18 (4.1) | 22 (3.1) | 4 (5.8) | 4 (7.1) | ||
| eGFR, mL/min/1.73 m2 | 54 (0.9) | |||||||
| < 15 | 313 (10.3) | 118 (8.6) | 17 (3.8) | 49 (6.7) | 3 (4.2) | 3 (5.4) | < .0001 | |
| 15-60 | 839 (27.5) | 444 (32.4) | 123 (27.5) | 228 (31.4) | 26 (36.1) | 24 (42.9) | ||
| > 60 | 1,788 (58.6) | 761 (55.5) | 301 (67.2) | 438 (60.3) | 41 (56.9) | 29 (51.8) | ||
| > 120 | 110 (3.6) | 47 (3.4) | 7 (1.6) | 11 (1.5) | 2 (2.8) | 0 (0) |
Data are presented as No. (%) or median (25th-75th percentiles) unless otherwise indicated. P values > .05, shown in bold, were considered statistically significant. CKD_ESRD = chronic kidney disease_end-stage renal disease, indication patient on dialysis; CRP = C-reactive protein; DDU = D-dimer unit; DM = diabetes mellitus; eGFR = estimate glomerular filtration rate; HTN = hypertension; LDH = lactate dehydrogenase. Chi-square, Fisher exact, or Kruskal-Wallis tests were used to compare statistical significance, between groups, as appropriate. Demographics and comorbidity data were obtained at baseline on admission. Vasopressor and invasive mechanical ventilation use was within 24 h before T0. Laboratory values included the closest value to T0 from within 96 h before T0. CRP, ferritin, LDH, and D-dimer were defined within 96 h before T0 and up to 12 h after T0 because of laboratory ordering practices.